Combatting Stigma

            Stigma is the perennial opponent of mental health. Even though our society has grown more accepting of the realities of mental health, there is still a stigma surrounding the topic. This should come as no surprise, however, due to the way that our society is built. Our society was designed to maintain the norm, highlight the extraordinary, and disregard the outliers (to which mental health patients belong). Additionally, we were taught to downplay mental health issues for generations. Health conditions such as depression or anxiety were equated to nothing more than mood swings that can be solved through other means. On top of that practice, activities like going to therapy or couples counseling were met with detrimental judgment and misunderstanding. It comes as no surprise that the urban fabric of today’s cities was designed around this antiquated mentality.

            It goes without saying that whether we like it or not, architecture has played a significant role in perpetuating this stigma.

            Thankfully, architects and designers have begun moving away from unconscious participation to conscious advocacy. Mental health advocates have started creating a more unified front to combat the perennial opponent and on top of that, the use of psychology, behavioral science, and neuroscience (to name a few fields) are all being integrated into the design process to create better spaces not only for those with serious cases but also for the general populace. This wave of societal and architectural enlightenment is a promising counter-offensive to the misinformation and stigma that still surrounds mental health.

            However, the question remains, how do we thoroughly combat misinformation and stigma? The answer lies within the construct of modern society itself!

            As I stated earlier, our society was designed to maintain the norm, highlight the extraordinary, and disregard the outliers – so where in this statement does the solution lie? It lies within the maintenance of the norm. Almost everything situated in the city is there to help maintain the status quo or to aid in the everyday life. Following Maslow’s Hierarchy of Needs, cities are designed to fulfill the basic needs of society. While the basic needs are met, there are limited provisions to deal with the growing issue of mental health – the reason for this is primarily because this issue isn’t a part of the norm until now. According to Mental Health America, 1 out of 5 Americans lives with a mental health condition – with the experience occurring to many more people than before it would be pointless to object that this is the new normal. The new normal currently is that mental health issues occur more often and that mental health is something to truly take care of. In summary, the norm of the generation has mental health tied to it. It’s not something to take for granted or take lightly.

            Since mental health is now a priority and a part of the norm, as designers we can draw two relevant conclusions from this. Firstly, if the norm now includes the consideration of mental health, we must always design with these factors in mind. Secondly, the normalization of the issue would further aid the treatment and advancement of mental health architecture for the more serious cases.

            Additionally, this gives us two targets for the advancement of psychiatric design: first, we must weave mental health architecture into the urban fabric of today’s cities, and second, we must clarify the goals we have set vis-à-vis psychiatric design.

            Regarding my first point, mental health architecture must be woven into the fabric of today’s cities. For example, AA meetings shouldn’t be automatically held at church basements. The sheer act of holding these meetings in somewhat hidden or ‘shady’ (for lack of a better term) locales (in the context of a basement, not a church) worsens the stigma surrounding the act of recovery. Additionally, what can be perceived as a simple issue of substance abuse can already warrant a check-up with a mental health professional. The fact is the infrastructure designed to deal with the outliers and mental health issues is poor and needs dire improvement. As designers, we can add spaces and infrastructure to help aid the day-to-day issues of mental health design. In offices, employees should be given proper rest spaces and wellness spaces in the form of elevated parks or open spaces within the office building. Shopping malls can host more green/open spaces to break the monotony of the typology. Communities should have better spaces for communal gathering – this means suburbs or neighborhoods should have a better allotment of open spaces for gatherings and places like apartment buildings, apartment complexes, or condos should be mandated to have a percentage of the total area turned into open/wellness spaces.

            Regarding my second point, asylums, or psychiatric hospitals, have often veered toward a faceless form of architecture. The architecture that has propagated with the typology is boring, depressing, and feels counter-intuitive to the goals set by the space. From a design point of view, it looks more like a prison than a healthcare space. This, in a nutshell, is exactly the fault of the designer to the context and the stakeholder. The typology valued efficiency and formality over humanity. Moving forward, we must focus on a more emphatic and informed form of design. Nowadays, we have organizations that help push this combined initiative – organizations like the Academy of Neuroscience for Architecture come to mind when discussing this topic. While their work is not specific to psychiatric design, the advancements in design parameters given that they’re influenced by neuroscience are nothing short of a breakthrough for health architecture.

            With that in mind, psychiatric facilities should be designed with healthcare professionals and with an updated mentality on healthcare systems. We must now move forward in the design process with an enlightened understanding that what we design can help shape future generations.

            As for me, I believe that psychiatric facilities have plenty of room for improvement in two main aspects: the integration of greeneries and the integration of the space in an urban context. The greeneries are aimed to improve the aesthetic and program of the facility while the integration of space allows the patients to be better reintegrated back into society. Studies have shown that adding greeneries to healthcare spaces helps aid the recovery of patients. Adding spaces like community gardens that can be used for a plethora of activities (i.e. gardening, an art space, communal space, etc.) can help the patients heal using different techniques and learn different skills. Perhaps they can plant fruits and vegetables that they’ll eventually eat in the facility – this concept creates an active healing process that allows the patients to determine the pace of their treatment and encourages them to participate, allowing for a better reintegration with society. Furthermore, the idea of adding more greeneries into the design can shake up the way facilities are designed. For example, instead of utilizing a hospital-like mono-form, why not split the form up into smaller tributary-like blocks that form part of the whole? That way the patients spend less time indoors and more time in their healing community.

            If the goal of a psychiatric facility is to prepare patients to be reintegrated into society, then more of the program of these facilities should be dedicated to that cause, as opposed to focusing on the efficiency of the design, which brings me to my second goal. Spaces like these should be situated in locales just outside major cities or major areas, if not within these areas. This idea allows more people to see that it is normal for everyday people to experience mental health issues, regardless of the magnitude. At the same time, this eliminates the ‘creepy mental asylum’ aesthetic or location that some facilities have fallen victim to. We must present the reality and combat the media-created perception that this typology only caters to comical supervillain-esque types or haunted house murderer types. Again, we must reiterate the reality of the situation as opposed to the perception created by the media – this concept ensures that the zoning of these facilities makes it easier for their families to visit and at the same time it would allow for an easier reintegration to society.

            In conclusion, we must combat the stigma by bringing to light the reality of the situation – mental health issues are nothing to be ashamed about. Especially because modern society has created an atmosphere that perpetuates mental health issues. Just like the old saying goes, prevention is better than cure – this philosophy is the one we need to follow. However, when the need for cure is apparent we must also have the proper, up-to-date facilities to deal with the issue.